scholarly journals Economics Risks of and Growth of the High Deductible Health Plan Among Patients With Cognitive Impairment

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 102-103
Author(s):  
Kevin Lu ◽  
Sam Li ◽  
Jing Yuan ◽  
Minghui Li
Keyword(s):  
Health Care ◽  
Cognitive Impairment ◽  
Health Plan ◽  
Unintended Consequences ◽  
Financial Access ◽  
Effective Care ◽  
Confounding Variables ◽  
Interview Survey ◽  
High Deductible Health Plan ◽  
Care Costs

Abstract OBJECTIVES: High Deductible Health Plan (HDHP) is characterized by higher deductibles and lower monthly premiums. Nevertheless, health economists are concerned that HDHPs may reduce or delay needed care, which will ultimately lead to poorer access to care for chronically affected participants. The objectives of this research are 1) to investigate the HDHP enrollment trend over the past decade; and, 2) to determine the effects of HDHP on risks of financial access risks among adults with cognitive impairment (CI). METHODS: Data were obtained between 2010-2018 from National Health Interview Survey (NHIS). Financial access to healthcare was assessed based on 6 survey questions by CDC. For data analysis, simple T tests and Chisq tests were used where appropriate, with multi-variable logistic regressions implemented to evaluate the effects of HDHP on risks of financial access. RESULTS: Of the 103,649 enrollments, 1,148 were with cognitive impairment and 102,501 were without CI diagnosis. A 55% increase in HDHP registers with cognitive impairment was observed from 2010 (30.50%) to 2018 (47.24%). After controlling for confounding variables, patients with HDPHs were more likely to have risks of financial access compared to those without HDHP (OR= 1.313, 95% CI, 1.002-1.719, p=0.0483). CONCLUSIONS: HDHPs are intended to support effective care options and reduce health care costs. Our research among CI patients with HDHP experienced more financial access risks than those without HDHP, indicating that HDHPs might have unintended consequences of healthcare usage. Employers and health care decision-makers may need to consider providing compensation to those HDHP enrollers with CI.

scholarly journals A unique partnership between a health system’s insurance plan and the Integrative Medicine Department benefits patients and helps control costs

2016 ◽  
Vol 5 (4) ◽  
pp. 61
Author(s):  
Maureen M Anderson ◽  
Karen Armstrong ◽  
Katherine Nori Janosz ◽  
Michael Tocco ◽  
Nancy A DeVore ◽  
...  
Keyword(s):  
Health Care ◽  
Integrative Medicine ◽  
Health Care Costs ◽  
Treatment Options ◽  
Cost Savings ◽  
Clinical Results ◽  
Insurance Plan ◽  
Effective Care ◽  
Wide Range ◽  
Care Costs

Health care costs continue to increase, affecting patients and insurance providers. Complementary health approaches are increasingly used to augment traditional medicine, and integrative medicine (IM) incorporates these complementary approaches into traditional patient care. The IM Department was established in our institution in 2004 and now offers a wide range of services to patients. Our institution offers health care coverage to all benefit-eligible hospital personnel and their eligible dependents. The use of IM has had a surprising and beneficial effect on the health care costs of this small, self-insured health plan. We found that the coverage of certain IM modalities for specific conditions had positive clinical results and resulted in significant cost savings to the insurance plan. At the same time, this partnership supports patients by providing appropriate and effective care, and we have seen success in terms of patient recovery and patient satisfaction. Here, we present the history of the relationship between the insurance plan and the IM Department, how the coverage of IM modalities has expanded, and the current practice at our institution. We demonstrate that this innovative relationship has benefitted patients and resulted in cost-savings for the insurance provider. Therefore, this partnership will continue to expand, thus providing patients with a wide range of treatment options and effective care.

Retrospective claims analysis of palliative care costs and survival in a U.S. metastatic renal cell (mRCC) population.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 433-433
Author(s):  
Henry J. Henk ◽  
Connie Chen ◽  
Agnes Benedict ◽  
Jane Sullivan ◽  
April Teitelbaum
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Health Plan ◽  
Index Date ◽  
Claims Data ◽  
Cohort Analysis ◽  
Hospital Costs ◽  
Best Supportive Care ◽  
Study Cohort ◽  
Care Costs

433 Background: Survival and costs outcomes for patients with mRCC receiving palliative or best supportive care (BSC) after stopping active therapy have been poorly characterized. This information is important to understand how resources are utilized at the end of life and to put current treatment costs into perspective. The objective of this retrospective database analysis was to examine survival and costs associated with BSC after receiving 1 or 2 lines of mRCC treatment. Methods: A retrospective cohort analysis using claims data from commercially insured or Medicare Advantage (MCR) enrollees of a large US health plan, with medical and pharmacy benefits. The study cohort consisted of patients with an index diagnosis for RCC [ICD-9-CM 189.0] from 1/1/07 to 6/30/10 initiating any of the following treatments from 30 days prior to index date through disenrollment: sunitinib, temsirolimus, sorafenib, bevacizumab, everolimus, pazopanib, cytokines. Patients were required to have a 6 mos. continuous enrollment ± index date (patients disenrolling due to death within the 6 mos. were retained). Lines of therapy (LOT) were identified based on prescription fill and administration dates, began following the last LOT and continued until disenrollment. Health care costs reported represent the health plan + patient paid amount. Results: The overall study cohort (n=274) was 73% male; mean (±SD) age 63.3 ± 11.1 yr. with the majority of patients commercially insured (80% vs 20% MCR). The majority started BSC following 1st LOT (68% vs 32%). Median survival from start of BSC was similar following 1st and 2nd LOT (126 and 118 days). The mean (median) duration of BSC after 1 LOT was 223 (114) days and 176 (109) days for 2 LOT. Total health care costs incurred during BSC averaged $50,187 ± 96,984 and $37,294 ± 51,101 and monthly costs were similar ($10,284 ± 17979) after 1 and 2 LOT, respectively. In both cases, inpatient hospital costs represented the largest proportion of these costs (47%) while outpatient costs represented 36%. Conclusions: Our study estimating BSC survival and costs in patients with mRCC based on US claims data found monthly cost of $10, 284. These estimates suggest that BSC costs are not insignificant.

Health Plan Choice and Information about Out-of-Pocket Costs: An Experimental Analysis

2001 ◽  
Vol 38 (1) ◽  
pp. 35-48 ◽  
Author(s):  
Michael Schoenbaum ◽  
Mark Spranca ◽  
Marc Elliott ◽  
Jay Bhattacharya ◽  
Pamela Farley Short
Keyword(s):  
Health Care ◽  
Health Plan ◽  
Good Health ◽  
Health Plans ◽  
Support Materials ◽  
Health Plan Choice ◽  
Plan Choice ◽  
Working Age ◽  
Care Costs ◽  
Out Of Pocket Costs

Many consumers are offered two or more employer-sponsored health insurance plans, and competition among health plans for subscribers is promoted as a mechanism for balancing health care costs and quality. Yet consumers may not receive the information necessary to make informed health plan choices. This study tests the effects on health plan choice of providing supplemental decision-support materials to inform consumers about expected health plan costs. Our main finding is that such information induces consumers to bear more risk, especially those in relatively good health. Thus our results suggest that working-age, privately insured consumers currently may be over-insuring for medical care.

scholarly journals Reliability of a patient survey assessing cost-related changes in health care use among high deductible health plan enrollees

2011 ◽  
Vol 11 (1) ◽  
Author(s):  
Robert B Penfold ◽  
Jeffrey T Kullgren ◽  
Irina Miroshnik ◽  
Alison A Galbraith ◽  
Virginia L Hinrichsen ◽  
...  
Keyword(s):  
Health Care ◽  
Health Plan ◽  
Patient Survey ◽  
Health Care Use ◽  
High Deductible Health Plan

Health care costs of people referred to an aged care assessment team: the effect of cognitive impairment

1997 ◽  
Vol 21 (3) ◽  
pp. 311-316 ◽  
Author(s):  
Dina LoGiudice ◽  
Wendy Waltrowicz ◽  
David Ames ◽  
Kaye Brown ◽  
Colin Burrows ◽  
...  
Keyword(s):  
Health Care ◽  
Cognitive Impairment ◽  
Health Care Costs ◽  
Aged Care ◽  
Care Assessment ◽  
Care Costs

scholarly journals Comparing Health Care Financial Burden With an Alternative Measure of Unaffordability

2017 ◽  
Vol 54 ◽  
pp. 004695801773296
Author(s):  
Edward S. Kielb ◽  
Corwin N. Rhyan ◽  
James A. Lee
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Medical Care ◽  
Health Care Costs ◽  
Health Plan ◽  
Low Income ◽  
Access To Health Care ◽  
Financial Burden ◽  
Access To Health ◽  
Care Costs

Health insurance plans with high deductibles increase exposure to health care costs, raising concerns about how the growth in these plans may be impacting both the financial burden of health care expenditures on families and their access to health care. We find that foregoing medical care is common among low-income, privately insured families, occurring at a greater rate than those with higher incomes or Medicare coverage. To better understand the relationship between out-of-pocket (OOP) spending and access, we used the 2011-2014 Medical Expenditure Panel Survey (MEPS) data and a logistic model to analyze the likelihood of avoiding or delaying needed medical care based on health insurance design and other individual and family characteristics. We find that avoiding or delaying medical care is strongly correlated with coverage under a high-deductible health plan, and with depression, poor perceived health, or poverty. However, it is relatively independent of the percent of income spent on OOP costs, making the percent of income spent on OOP costs by itself a poor measure of health care unaffordability. Individuals who spend a small percentage of their income on health care costs may still be extremely burdened by their health plan when financial concerns prevent access to health care. This work emphasizes the importance of insurance design as a predictor of access and the need to expand the definition of financial barriers to care beyond expenditures, particularly for the low-income, privately insured population.

scholarly journals Health care costs in the last four years of life for private health plan beneficiaries in Brazil

2008 ◽  
Vol 24 (2) ◽  
Author(s):  
Marcos Bosi Ferraz ◽  
Isaura Cristina Miranda ◽  
Jorge Padovan ◽  
Patricia Coelho de Soárez ◽  
Rozana Ciconelli
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Health Plan ◽  
Care Costs
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